ICF Model and Goal Writing in Paediatrics: Difference between revisions

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== ICF ==
<div class="editorbox"> '''Original Editor '''- [[User:Robin Tacchetti|Robin Tacchetti]] based on the course by
ICF which stands for the International Classification of Functioning, Disability and Health is a World Health Organization classification of health and health-related arenas.  This framework measures health and disability at both the individual and population levels while also looking at environmental factors.<ref>Barlett CP, Madison CS, Heath JB, DeWitt CC. Please browse responsibly: [https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health A correlational examination of technology access and time spent online in the Barlett Gentile Cyberbullying Model]. Computers in Human Behavior. 2019 Mar 1;92:250-5.</ref>This framework emphasises function, impact and health rather than disability and cause. <ref>World Health Organization. [https://cdn.who.int/media/docs/default-source/classification/icf/icfbeginnersguide.pdf?sfvrsn=eead63d3_4&download=true Towards a common language for functioning, disability, and health]: ICF. The international classification of functioning, disability and health. 2002.</ref>
[https://members.physio-pedia.com/course_tutor/krista-eskay/ Krista Eskay]<br>
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>


Jiandani MP, Mhatre BS. Physical therapy diagnosis: How is it different?. Journal of postgraduate medicine. 2018 Apr;64(2):69.So we're talking about not only their impairments and potential medical diagnosis,


Rast FM, Labruyère R. ICF mobility and self‐care goals of children in inpatient rehabilitation. Developmental Medicine & Child Neurology. 2020 Apr;62(4):483-8.  https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.14471<nowiki/>0:53


Houtrow A, Murphy N, Kuo DZ, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH. Prescribing physical, occupational, and speech therapy services for children with disabilities. Pediatrics. 2019 Apr 1;143(4).https://publications.aap.org/pediatrics/article/143/4/e20190285/37233/Prescribing-Physical-Occupational-and-Speech
== Introduction ==
The [[Overview of the ICF and Clinical Practice|International Classification of Functioning, Disability and Health (ICF)]] is a World Health Organization classification of health and health-related domains. This framework measures health and disability at both the individual and population levels while also looking at environmental factors.<ref>Barlett CP, Madison CS, Heath JB, DeWitt CC. Please browse responsibly: [https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health A correlational examination of technology access and time spent online in the Barlett Gentile Cyberbullying Model]. Computers in Human Behavior. 2019 Mar 1;92:250-5.</ref> This framework emphasises function, impact and health rather than disability and cause.<ref>World Health Organization. [https://cdn.who.int/media/docs/default-source/classification/icf/icfbeginnersguide.pdf?sfvrsn=eead63d3_4&download=true Towards a common language for functioning, disability, and health]: ICF. The international classification of functioning, disability and health. 2002.</ref> Understanding the functional deficits associated with a health condition promotes better patient management. The [[Overview of the ICF and Clinical Practice|ICF]] offers a more holistic model of health, which utilises goal setting, and requires the evaluation of outcomes and communication among colleagues.<ref name=":0">Jiandani MP, Mhatre BS. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954814/ Physical therapy diagnosis: How is it different?]. Journal of postgraduate medicine. 2018 Apr;64(2):69.</ref>


but we're also looking at a multitude of contextual factors that really have an influence on how that
== ICF Model ==
[[File:ICF Model Generic (correct version).png|thumb|450x450px|Figure 1. ICF Model.]]
The ICF framework is a biopsychosocial model, which intertwines medical and social models of disability. The ICF framework recognises that one's health is shaped by environmental and personal factors. The ICF can be separated into three components of health:


individual is able to participate in their daily activities or activities that are of importance to them.
# Body functions and structures
# Activities
# Participation
Then, there are contextual factors that influence an individual's life:
# Environmental factors
# Personal factors


So when we talk about this, you can break down the ICF model into three components of health.
Body functions refers to the physiological functions of body systems. Body structures refers to the anatomical parts of the body (e.g. organs, limbs etc). Activities and participation refer to involvement in life events and the implementation of various tasks. Environmental factors are the attitudinal, social and physical environments where people conduct and live their lives. Personal factors might relate to the individual and their family.<ref name=":3" /><ref>Eskay K. ICF Model and Goal Writing Course. Plus. 2022.</ref><blockquote>
==== Special Topic: the ICF and Paediatric Rehabilitation ====
"The ICF describes the relationship between health conditions diagnosed and coded in the ICD [International Classification of Diseases] and the personal and environmental factors that act as facilitators or barriers to functioning. There are 3 identified levels of functioning: the body part or organ system, the person, and the person in social situations. These levels correspond to body functions, activities, and participation, respectively. Disability is the umbrella term for impairments at the body part or organ system level, activity restrictions at the person level, and participation restrictions at the person-in-society level. The WHO defines impairments as “problems in body function or structure such as a significant deviation or loss,” activity limitations as “difficulties an individual may have in executing a task,” and participation restrictions as “problems an individual may experience in involvement in life situations.”


So these components of health are going to include the body function, functions and body structures
The ICF also includes the concepts of capacity and performance. Capacity is the individual’s intrinsic ability to perform a task or an action in a standardized environment, whereas performance is how well the individual is able to actually perform the task in his or her own real-life environment. These concepts are important in understanding the role of habilitative and rehabilitative therapies for children with disabilities, because achievement of skill requires extensive practice and must be integrated into the child’s routine for the successful enhancement of participation in life events. In addition, the ICF framework highlights the importance of a child’s environment on his or her functional outcomes. The environment includes not just the physical world, such as the town where the child lives or the topography of the community, but also includes the attitudes and values of the family, community, and society at large and the technologies, services, supports, laws, and policies where the child lives. Access to health and therapeutic services, the physical environment, and social supports all affect how well a child with disabilities functions in his or her daily life."<ref name=":4" />


Always make sure that you really have a good concept of what their participation restrictions are and what their participation goals are.  But some important key factors to remember is that not all impairments are going to be able to be modified by you.
-Houtrow et al 2019</blockquote>


So that's something that you're going to want to keep in mind whenever you're looking at what
== Functional Limitations ==
It is important during rehabilitation evaluation to determine what functional limitations the individual has. For example, physiotherapists are interested in learning how the individual's functional limitations are inhibiting or restricting their activity and participation; occupational therapists are interested in how their ability to complete activities of daily living are effected. Activity refers to the ability of the individual to execute a task or action, whereas participation is the ability to fulfill a socially defined role. Participation can relate to activities with family, at work and/or with peer groups. The [[ICF and Application in Clinical Practice|ICF]] framework considers immediate or distant factors that might facilitate or hinder overall functioning, including:


their impairments are and what sort of effect you might have through your interventions.
* Environmental factors
** Setting at home
** Setting at school
** Motivation of the individual
** Amount of family support
** Accessibility to assistive devices<ref name=":0" />
* Personal factors
** Age
** Gender
** Lifestyle
** Fitness
** Coping styles
** Cultural beliefs
** Pain experience<ref name=":0" />


And not all impairments necessarily are going to limit their ability to participate in an activity of interest.
== Interventions ==
The plan of care is created once the impairments, functional limitations and activity limitations have been identified.  Interventions are targeted at minimising disability and using function as an outcome.<ref name=":0" /> Within the paediatric population, the [[ICF and Application in Clinical Practice|ICF]] emphasises the importance of a child's environment on their functional outcomes. The environment encompasses not just the physical world, but the values and attitudes of the family and community. Accessibility to services and support will affect overall daily function for a child with functional impairments.<ref name=":4">Houtrow A, Murphy N, Kuo DZ, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH. [https://publications.aap.org/pediatrics/article/143/4/e20190285/37233/Prescribing-Physical-Occupational-and-Speech Prescribing physical, occupational, and speech therapy services for children with disabilities]. Pediatrics. 2019 Apr 1;143(4).</ref>


So just because maybe he does have decreased force protection, maybe he doesn't care if he's going to do the high jump or the long jump.
== Goal-Setting ==
The [[ICF and Application in Clinical Practice|ICF]] framework can be helpful for goal-setting. Goals are created to increase activity and participation, which are impacted by functional impairments.<ref name=":1" /> <ref name=":2">Eskay, K.  ICF Model and Goal-Writing Course.  Physioplus. 2022</ref> Goal creation favours the strengths of the child and focuses on how to build on these strengths to accomplish new tasks.<ref name=":2" /> Within the paediatric population, a family-centred approach is adopted when setting goals.<ref name=":1">Rast FM, Labruyère R. I[https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.14471 CF mobility and self‐care goals of children in inpatient rehabilitation]. Developmental Medicine & Child Neurology. 2020 Apr;62(4):483-8</ref> This sort of collaboration enables the patient and family to highlight their interests and provide assistance in intervention planning.<ref name=":3" />  Research has shown that a family-/patient-centred approach can increase patient motivation and improve therapy outcomes.<ref name=":3" /> 


So again, always, always, always make sure that you're relating your impairments and activity limitations to participation limitations,
== SMART Goals ==
When creating meaningful functional goals, the SMART method is recommended.  The acronym SMART stands for:


because that's really kind of the golden standard for what's important for us to work on as physiotherapists.
* S: specific
* M: measurable
* A: attainable
* R: realistic
* T: time-limited<ref name=":3">Angeli JM, Schwab SM, Huijs L, Sheehan A, Harpster K. [https://pubmed.ncbi.nlm.nih.gov/31766925/ ICF-inspired goal-setting in developmental rehabilitation: an innovative framework for pediatric therapists]. Physiotherapy theory and practice. 2021 Nov 2;37(11):1167-76.</ref>
Using the SMART acronym, rehabilitation professionals can ensure they have set realistic goals for the child that are attainable. Goals are typically geared for the short term or long term depending on the particular task.<ref name=":2" />


And make sure you find out what's important to that child, to their family,
== Resources ==


so that you're creating goals that are something that they actually want to work on,
* [[Introduction to the International Classification of Functioning, Disability and Health (ICF)]]


because a lot of this can be pretty hard for the families and the children to have
* [[ICF Educational and Clinical Resources]]


carry over for when we're coming up with interventions that are appropriat
* [[ICF and RPS within Cerebral Palsy]]


So his ability to participate is really variable based on that environment and some of these different contexts
* [[International Classification of Functioning, Disability and Health (ICF)]]


the things that they want to do, you are the ultimate goal of our interventions.
* [[Overview of the ICF and Clinical Practice|Overview of the ICF in Clinical Practice]]


So when we talk about this ICF model and really breaking down all of this information that we get from our examination and from our evaluation,
== References ==
 
<references />
when we try to come up with goals for this patient in their family,
[[Category:Rehabilitation]]
 
[[Category:ReLAB-HS Course Page]]
we really want to go back to the things that are important to that family and that patient for them to participate,
[[Category:Course Pages]]
 
[[Category:Paediatrics]]
to have that highest quality of life.
 
So moving into developing that goal, like we talked about, there's activity and participation goals are going to be key.
 
So you're going to listen to what the patient and the family have to say for what's important to them.
 
And then from that, you are going to look at how you can potentially increase their function and how you can improve their
 
activities and their participation so that they can do these things that they want to do more easily.
 
So you want to make sure that when you're developing these goals,
 
you're doing it in collaboration with the family and that a lot of these things that are important to the family are going to be like,
 
how you do just basic tasks during the day, like changing their clothes, changing their diaper.
 
You also want to make sure you think about what the strength of that child in that family are.
 
Maybe they have a really great support system.
 
nd then you want to also make sure that you're thinking about what you can
 
actually do as a physiotherapist that's going to assist in achieving that goal.
 
So how do we come up with all this information?
 
Well, of course, to fill out an ICF model, to be able to have an idea about what the patient wants to do,
 
to have an idea about their limitations and their body structures and functions, we have to get that really nice,
 
thorough history and examination and make sure we have really good tests and measures that are specific for that particular patient population.
 
We are going to want to identify the different impairments in body structure and function in their participation restrictions.
 
And we're going to look at, you know, what is the prognosis of this particular patient and what factors are influencing
 
that prognosis to make sure that we can come up with attainable goals? So for example, let's say that you have a child who has spastic Julija,
 
And that might be something that is a little bit of a difficult goal to achieve.
 
So you want to make sure that you're setting realistic goals that are attainable and achievable for that particular patient.
 
You also want to think about how long it's going to take to achieve that goal. So we're thinking about our goal setting.
 
We're going to look at how long we think that particular plan of care for that patient
 
is going to be and identify goals that can be completed within that timeline.
 
Often when we make goals, we're talking about developing some short term goals and some long term goals, depending on the patient.
 
The length of those goals can be different. So a lot of times, you know, I'm setting some short term goals that are four and six weeks and time,
 
and then we're going to do a check in to see how they're doing and then some longer term goals that might be more in the 12 16 weeks time period.
 
And that's going to change depending on why you're seeing a patient.
 
So for example, let's say you have a patient with developmental delay.
 
You're probably going to see them for episodes of care for a longer period of time.
 
So you might have goals that extend a little longer. Or maybe you have things that you think, Oh yeah, you'll be able to get this pretty quickly.
 
Or maybe you have a child who has Down syndrome. And we know that it takes them longer to achieve particular gross motor skills.
 
So your plan of care might extend a little bit longer in those particular cases.
 
So keep these factors in mind whenever you're thinking about how long it's going to take to achieve a particular kind of goal.
 
And then always, always, always make sure that it's important to the patient and important to the caregivers.
 
So when we talk about smart goals, really what we mean is, you know,
 
making a goal that has a lot of different features to it that are going to allow you to reassess it in a very specific kind of way.
 
We want these goals to be objective as much as possible so that we know whether or not we achieved that goal.
 
So the smart goal is really an acronym.
 
So the smart goal is really an acronym.
 
And what it stands for is the essence in the smart is we're specific, so we want to make sure our goal is specific.
 
So we want to make sure that when we're thinking about something that it has,
 
like all of the components, tell us to say yes, this is the thing we are doing.
 
So maybe it's that we want Thomas to be able to walk to school.
 
All right. So where is he going? He's not just walking. Is walking to school.
 
Where is he walking from? From his house, from grandmother's house or so?
 
Thomas is going to be able to walk from his house to his school, and maybe we want him to do this three out of five days each week.
 
All right. So now we know where he's walking and we know how many days a week he's doing it.
 
Well, how far is it? You know, is it that detour with construction?
 
So OK, maybe it's one mile. So now Thomas is walking three out of five days a week from his house to his school over one mile distance.
 
So now we have all of these very specific components of where Thomas is walking.
 
The next thing that we're going to look for in our goal is that it's measurable. So we have to have some way to give some context to the goal.
 
So. All right. Maybe he's walking there, but does it count if it takes him three hours to get there?
 
That probably doesn't make sense, right?
 
I mean, he can't spend three hour, three hours of his day walking to school and then another three hours of his day walking home from school.
 
He's going to be too exhausted to know anything that happened during the school day, and he's probably going to miss most of it.
 
So maybe we want him to be able to do that walk to school three to five days of the week.
 
That's going to take him. It's going to be over one mile distance, and maybe we want him to be able to do that in 40 minutes.
 
And we think that's a reasonable amount of time. Family thinks that's reasonable. So, OK, now it's measurable.
 
It's going to take him 40 minutes to do that particular task.
 
And the next part of the goal is you want to make sure it's attainable. Can Thomas actually do this?
 
So you want to make sure that you're thinking about, all right, like, is this something that we're actually going to be able to get him to?
 
Because if it's not attainable, if it's not achievable, you're not setting a good goal for him.
 
You know, maybe you've done tested measure and you've done a six minute walk test.
 
And you know, his endurance completely plummeted. You know, his vitals were through the roof.
 
He had, you know, a piece or some sort of, you know, rating of,
 
like how hard he felt like he was working and it was a nine out of 10 with only six minutes of walking.
 
Do we really think that we're going to get him to be able to go a mile? Maybe not so attainable.
 
So I want to make sure this is something that he can do. And, you know, like, it has to be realistic.
 
So, you know, is this something that your goal is both achievable and you think you can do it in a timeframe that's realistic?
 
So you know you're going to set a plan of care for maybe 16 weeks? Is he going to be able to get there in 16 weeks?
 
Or maybe it's going to take him being four years older and that, you know,
 
he's not going to have that detour anymore before it's actually a realistic goal for him to do this.
 
nd then lastly, you want to make sure you have that time frame. So how long is it going to take for you to achieve this goal?
 
So in 12 weeks time? Thomas is going to be able to walk from his house to the school three to five days of the week.
 
it's going to be over a mile distance and he is going to do this in under 40 minutes.
 
Maybe there are other measurable components you want to do with a piece or some sort of perceived reading of exertion,
 
scale of a lesson in six out of 10 or,
 
you know, with a certain type of gait or, you know, with one person there to assist by providing close supervision only.
 
So you can add in lots of other specific components to that or measurable components to that.
 
Make sure it's attainable. This is something that, yeah, we totally think he can do this and we think he can do it within like a single plan of care.
 
At the age he's in with the potential barriers that are in his way, and we think that he can do this in that 12 week period of time.
 
So when you have all of that together, there is no question as to whether or not he did or did not achieve his goal because you have all of the
 
components of this goal that are set up really beautifully for you to be able to then objectively say yes or no.
 
And what do we need to modify as we move forward to make it a little more realistic,
 
attainable or achievable if we're not seeing the progress that we anticipated to?
 
So just going through a different patient and this is something that you're going to use for another knowledge check here next,
 
so you can use this information as a reference.
 
So now we have Jonathan, who is a 14 year old boy with hemiplegia after a stroke at the age of 10 years old,
 
so he wound up with spasticity on his right anybody.
 
So right hand wrist finger flexor gastric solis.
 
So he's got decreased muscle extensibility, decreased range of motion and his calves, particularly.
 
He has really poor activation of his dorsal flexors. So he's got this spasticity that's putting his foot down.
 
t's really tough for him to fight and pull his toes up to get good foot clearance.
 
Because of that, he actually uses an AFO on that right foot for his community mobility to make sure he can get good toe clearance and of trepang,
 
often after participating in a full day of school. He is beat.
 
He is really tired. It takes a lot out of him. And when he goes home, he likes to take his AFO off, sometimes just because he needs a break from it.
 
And when he's at home, [INAUDIBLE] kind of furniture start from one thing to the next, and he does have a history of falls.
 
You know, sometimes from that fatigue,
 
sometimes from its toe catching whenever he's at home and not wearing his AFL family lives in a two storey home.
 
And there are six steps to get into the house. Mom and dad both work full time jobs.
 
They're not at home whenever he gets home, and he has three younger siblings.
 
One of Jonathan's goals is that he really wants to be able to take his three and four siblings to the park across the street.
 
That's also up a hill from their home.
 
So this is information you've gathered so far in your examination and evaluation of Jonathan whenever he came into the clinic with mom and dad.
 
So what we're going to do is a little knowledge track to come up with two smart goals for Jonathan based on the previously provided information.
 
So I'm just going to pop that back up for you so that you can kind of jot down some notes if you need to before we go into our knowledge check.
 
And then that'll be it for us talking about the ICF model and goal setting for today.

Latest revision as of 07:40, 19 May 2024

Original Editor - Robin Tacchetti based on the course by

Krista Eskay

Top Contributors - Robin Tacchetti, Jess Bell and Stacy Schiurring


Introduction[edit | edit source]

The International Classification of Functioning, Disability and Health (ICF) is a World Health Organization classification of health and health-related domains. This framework measures health and disability at both the individual and population levels while also looking at environmental factors.[1] This framework emphasises function, impact and health rather than disability and cause.[2] Understanding the functional deficits associated with a health condition promotes better patient management. The ICF offers a more holistic model of health, which utilises goal setting, and requires the evaluation of outcomes and communication among colleagues.[3]

ICF Model[edit | edit source]

Figure 1. ICF Model.

The ICF framework is a biopsychosocial model, which intertwines medical and social models of disability. The ICF framework recognises that one's health is shaped by environmental and personal factors. The ICF can be separated into three components of health:

  1. Body functions and structures
  2. Activities
  3. Participation

Then, there are contextual factors that influence an individual's life:

  1. Environmental factors
  2. Personal factors

Body functions refers to the physiological functions of body systems. Body structures refers to the anatomical parts of the body (e.g. organs, limbs etc). Activities and participation refer to involvement in life events and the implementation of various tasks. Environmental factors are the attitudinal, social and physical environments where people conduct and live their lives. Personal factors might relate to the individual and their family.[4][5]

Special Topic: the ICF and Paediatric Rehabilitation[edit | edit source]

"The ICF describes the relationship between health conditions diagnosed and coded in the ICD [International Classification of Diseases] and the personal and environmental factors that act as facilitators or barriers to functioning. There are 3 identified levels of functioning: the body part or organ system, the person, and the person in social situations. These levels correspond to body functions, activities, and participation, respectively. Disability is the umbrella term for impairments at the body part or organ system level, activity restrictions at the person level, and participation restrictions at the person-in-society level. The WHO defines impairments as “problems in body function or structure such as a significant deviation or loss,” activity limitations as “difficulties an individual may have in executing a task,” and participation restrictions as “problems an individual may experience in involvement in life situations.”

The ICF also includes the concepts of capacity and performance. Capacity is the individual’s intrinsic ability to perform a task or an action in a standardized environment, whereas performance is how well the individual is able to actually perform the task in his or her own real-life environment. These concepts are important in understanding the role of habilitative and rehabilitative therapies for children with disabilities, because achievement of skill requires extensive practice and must be integrated into the child’s routine for the successful enhancement of participation in life events. In addition, the ICF framework highlights the importance of a child’s environment on his or her functional outcomes. The environment includes not just the physical world, such as the town where the child lives or the topography of the community, but also includes the attitudes and values of the family, community, and society at large and the technologies, services, supports, laws, and policies where the child lives. Access to health and therapeutic services, the physical environment, and social supports all affect how well a child with disabilities functions in his or her daily life."[6]

-Houtrow et al 2019

Functional Limitations[edit | edit source]

It is important during rehabilitation evaluation to determine what functional limitations the individual has. For example, physiotherapists are interested in learning how the individual's functional limitations are inhibiting or restricting their activity and participation; occupational therapists are interested in how their ability to complete activities of daily living are effected. Activity refers to the ability of the individual to execute a task or action, whereas participation is the ability to fulfill a socially defined role. Participation can relate to activities with family, at work and/or with peer groups. The ICF framework considers immediate or distant factors that might facilitate or hinder overall functioning, including:

  • Environmental factors
    • Setting at home
    • Setting at school
    • Motivation of the individual
    • Amount of family support
    • Accessibility to assistive devices[3]
  • Personal factors
    • Age
    • Gender
    • Lifestyle
    • Fitness
    • Coping styles
    • Cultural beliefs
    • Pain experience[3]

Interventions[edit | edit source]

The plan of care is created once the impairments, functional limitations and activity limitations have been identified. Interventions are targeted at minimising disability and using function as an outcome.[3] Within the paediatric population, the ICF emphasises the importance of a child's environment on their functional outcomes. The environment encompasses not just the physical world, but the values and attitudes of the family and community. Accessibility to services and support will affect overall daily function for a child with functional impairments.[6]

Goal-Setting[edit | edit source]

The ICF framework can be helpful for goal-setting. Goals are created to increase activity and participation, which are impacted by functional impairments.[7] [8] Goal creation favours the strengths of the child and focuses on how to build on these strengths to accomplish new tasks.[8] Within the paediatric population, a family-centred approach is adopted when setting goals.[7] This sort of collaboration enables the patient and family to highlight their interests and provide assistance in intervention planning.[4] Research has shown that a family-/patient-centred approach can increase patient motivation and improve therapy outcomes.[4]

SMART Goals[edit | edit source]

When creating meaningful functional goals, the SMART method is recommended. The acronym SMART stands for:

  • S: specific
  • M: measurable
  • A: attainable
  • R: realistic
  • T: time-limited[4]

Using the SMART acronym, rehabilitation professionals can ensure they have set realistic goals for the child that are attainable. Goals are typically geared for the short term or long term depending on the particular task.[8]

Resources[edit | edit source]

References[edit | edit source]

  1. ↑ Barlett CP, Madison CS, Heath JB, DeWitt CC. Please browse responsibly: A correlational examination of technology access and time spent online in the Barlett Gentile Cyberbullying Model. Computers in Human Behavior. 2019 Mar 1;92:250-5.
  2. ↑ World Health Organization. Towards a common language for functioning, disability, and health: ICF. The international classification of functioning, disability and health. 2002.
  3. ↑ 3.0 3.1 3.2 3.3 Jiandani MP, Mhatre BS. Physical therapy diagnosis: How is it different?. Journal of postgraduate medicine. 2018 Apr;64(2):69.
  4. ↑ 4.0 4.1 4.2 4.3 Angeli JM, Schwab SM, Huijs L, Sheehan A, Harpster K. ICF-inspired goal-setting in developmental rehabilitation: an innovative framework for pediatric therapists. Physiotherapy theory and practice. 2021 Nov 2;37(11):1167-76.
  5. ↑ Eskay K. ICF Model and Goal Writing Course. Plus. 2022.
  6. ↑ 6.0 6.1 Houtrow A, Murphy N, Kuo DZ, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH. Prescribing physical, occupational, and speech therapy services for children with disabilities. Pediatrics. 2019 Apr 1;143(4).
  7. ↑ 7.0 7.1 Rast FM, Labruyère R. ICF mobility and self‐care goals of children in inpatient rehabilitation. Developmental Medicine & Child Neurology. 2020 Apr;62(4):483-8
  8. ↑ 8.0 8.1 8.2 Eskay, K. ICF Model and Goal-Writing Course. Physioplus. 2022
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